Efficacy of splenectomy in preventing anemia in patients with recurrent hepatitis C following liver transplantation is not dependent on inosine triphosphate pyrophosphatase genotype

• Published in: Hepatology research Vol. 42; no. 3; pp. 288 - 295
• Main Authors: Motomura, Takashi, Koga, Erina, Taketomi, Akinobu, Fukuhara, Takasuke, Mano, Yohei, Muto, Jun, Konishi, Hideyuki, Toshima, Takeo, Uchiyama, Hideaki, Yoshizumi, Tomoharu, Shirabe, Ken, Maehara, Yoshihiko
• Format: Journal Article
• Language: English
• Published: Melbourne, Australia Blackwell Publishing Asia 01.03.2012
• Subjects: Anemia; Gene polymorphism; Hemoglobin; Hepatitis C; Hepatitis C virus; inosine triphosphate pyrophosphatase genetic polymorphism; Liver transplantation; pyrophosphatase; recurrent hepatitis C; Ribavirin; Splenectomy
• ISSN: 1386-6346; 1872-034X
• DOI: 10.1111/j.1872-034X.2011.00927.x

Aim:  A genetic polymorphism of inosine triphosphate pyrophosphatase (ITPA) has been associated with pegylated‐interferon/ribavirin (PEG‐IFN/RBV)‐induced anemia in chronic hepatitis C patients. However, correlation of the genetic variant with anemia following liver transplantation has not been determined. Methods:  Sixty‐three hepatitis C virus (HCV)‐positive patients who underwent liver transplantation and PEG‐IFN/RBV therapy were enrolled. The rs1127354 was determined for each individual. Results:  There was no relationship with anemia or RBV dosage in patients carrying the CC allele (CC group, n = 43) and those carrying the CA allele (CA group, n = 20). The incidence of hemoglobin (Hb) decline >3 g/dL (CC: 4.7%, CA: 0%) was relatively low, whereas the incidence of Hb levels <10 g/dL (CC: 18.6%, CA: 30.0%) was high. Univariate analysis revealed that splenectomy inversely correlated with Hb levels <10 g/dL at 4 weeks (P = 0.04). Among the 22 patients who did not undergo splenectomy, the incidence of Hb levels <10 g/dL tended to be lower in the seven patients carrying the CA allele (28.6%) than in the 15 patients with the CC allele (60.0%). Conclusion:  The ITPA genetic polymorphism does not correlate with post‐transplant PEG‐IFN/RBV‐induced anemia. Splenectomy is useful in preventing anemia regardless of the ITPA genotype.